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Ureteric Stricture Disease
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==Answers== #What are the causes of ureteral stricture disease? ##Stones ##Instrumentation, endoscopic ##Infection (TB) ##Radiation ##Renal ablation injury ##Ischemia ##Idiopathic ##Periureteral fibrosis #What are the management options for ureteral stricture disease? ##Diversion ##Endoscopic ##Surgical ###Ureteroureterostomy ###Ureteroneocystotomy ###Psoas hitch ###Boari flap ###Renal descensus ###Transureteroureterostomy ###Ileal ureter ###Autotransplant #What are the contraindications to transureterostomy? ##Absolute: insufficient length of ureter ##Relative: history of stones, upper tract cancer, RPF, radiation, chronic pyelonephritis, any process that affects both ureters #What investigations are needed before considering transureteroureterostomy? ##VCUG to rule out reflux #What are the contraindications to ileal ureter substitution? ##Baseline renal insufficiency ##Bladder dysfunction or outlet obstruction ##Inflammatory bowel disease ##Radiation enteritis #What is the preferred approach (retrograde vs. antegrade) for the endoscopic management of ureteroenteric stricture? ##Antegrade #What are the risk factors for failure of endourological management of a ureteroenteric anastamostic stricture? ##Left sided stricture ##Stricture > 1cm
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